Current Issues

Home » Current Issues

CMS Cuts Funding to Medicare Home Health Services

On October 31, 2022, the Centers for Medicare & Medicaid Services (CMS) released its Home Health Final Rule for 2023. After tremendous industrywide advocacy efforts, our united voices were heard. CMS finalized an increase of 0.7% for 2023 for Medicare Home Health providers, resulting in an additional $125 million in payment to the industry in 2023.

However, the fight is not over. CMS finalized a permanent 7.85% cut to Medicare home health services in the 2023 Home Health Prospective Payment System (HHPPS) Final Rule. CMS acknowledged that this significant cut would create an immense hardship for providers, and announced it would phase in half of the reduction—3.925%—for 2023, and implement the second half of the cuts beginning in 2024.

Home health providers along with our national partners are deeply disappointed that CMS finalized these cuts despite strong opposition from patients, providers, and lawmakers.

Ask Congress to Support Legislation to Stop Home Health Cuts!

  • Take Action: Click on the button below to send a pre-written email to your congressional representatives telling them to support the Preserving Access to Home Health Act, which would stop these cuts until 2026. This action only takes one minute to complete!
Take Action
  • Meet with your congressional representatives: We can help you set up meetings with your lawmakers and be there to facilitate the call with you. Email Maggie DiPasquale at [email protected] for more information on this effort.
  • Spread the word: Share our Facebook, Twitter, and Instagram social media posts with friends and family to get the word out about these devastating cuts.

What is Home Health?

Home health care is a wide range of health care services that can be given in your home for an illness or injury. Home health care is usually less expensive, more convenient, and just as effective as care you get in a hospital or skilled nursing facility (SNF).

Examples of skilled home health services include:

  • Wound care for pressure sores or a surgical wound
  • Patient and caregiver education
  • Intravenous or nutrition therapy
  • Injections
  • Monitoring serious illness and unstable health status

New CMS Rule Means Billions in Steep Rate Cuts to Home Health Care

  • The 85% permanent cut equates to more than $1 billion in cuts annually starting in 2024 and continuing in perpetuity. This will result in devastating, long-term repercussions for home health patients and their providers.
  • These cuts will total more than $18 billion over the next ten years – even more than what CMS originally proposed in its June Proposed HHPPS Rule.
  • CMS finalized calculations for additional “clawback cuts” of more than $2 billion for services provided to patients during the COVID-19 pandemic. On top of that $2 billion plus cut, an additional estimated $1.5 billion will be clawed back from home health providers for services delivered in 2022 and 2023 cut (as a result of CMS phasing in the cut).
  • More than half of Medicare-certified home health agencies will be operating under negative margins as a result of these cuts.
  • CMS finalized these cuts despite strong opposition from patients, providers, and lawmakers.
  • CMS ignored data and recommendations from home health leaders warning the agency’s methodology for justifying these cuts is deeply flawed and in violation of CMS’ statutory authority.

Legislation: Preserving Access to Home Health Act

The Preserving Access to Home Health Act of 2022 will make the following policy changes:

  1. Prevent CMS from implementing any permanent or temporary adjustment to home health prospective payment rates prior to 2026.This would delay cuts currently proposed by CMS for 2023 and beyond, allowing more time for CMS to refine its proposed approach to determining budget neutrality in home health.
  2. Ensure that any adjustments CMS determines to be necessary to offset increases or decreases in estimated aggregate expenditures are made by 2032, such that no cuts would be delayed beyond the end of the budget window.
  3. The legislation is intended to be self-implementing. It would become effective as of the date of enactment and includes instructions allowing for implementation by program instruction or other means.

To learn more about this issue, click here.